Cor Vasa 2002, 43(2):87-90
Unusual location of the substrate of fascicular idiopathic left ventricular tachycardia
- Cardiac Unit, Wentworth Hospital/University of Natal, Durban, KwaZulu/Natal, South Africa
A successful ablation of fascicular left ventricular tachycardia located on a false tendon in the left ventricle is presented. A high-frequency His-Purkinje potential was recorded along the fascicles as well as around the insertion and along the false tendon in sinus rhythm. The position of the mapping catheter was monitored by echocardiography. During tachycardia, early endocardial activation with an identical ECG pace map was recorded at the septum in the area of insertion, however, repeated attempts to ablate the tachycardia in this region failed. The earliest endocardial activation (V-QRS: -15 ms) preceded by a high- frequency Purkinje cell potential was found on the tendon within the left ventricular cavity and the tachycardia was ablated at this site. The successful ablation on the false tendon within the left ventricular cavity and the evidence of a Purkinje cell potential on the band suggest that the substrate of "fascicular" idiopathic left ventricular tachycardia might be associated with distal Purkinje cell networks rather than with the fascicles.
Keywords: Fascicular left ventricular tachycardia; Substrate; False tendon; Catheter ablation
Published: February 1, 2002 Show citation